Provider Demographics
NPI:1790520369
Name:QUIDILIG, GINA CLAUNA (SUD APPRENTICES)
Entity type:Individual
Prefix:
First Name:GINA
Middle Name:CLAUNA
Last Name:QUIDILIG
Suffix:
Gender:F
Credentials:SUD APPRENTICES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1177 MARKET ST APT 1144
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94103-1823
Mailing Address - Country:US
Mailing Address - Phone:415-678-7201
Mailing Address - Fax:
Practice Address - Street 1:815 BUENA VISTA AVE W
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-4108
Practice Address - Country:US
Practice Address - Phone:415-554-1450
Practice Address - Fax:415-554-1475
Is Sole Proprietor?:No
Enumeration Date:2024-06-26
Last Update Date:2024-06-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)